How Often Do I Need to Get My HIV Labs Done?

Joel Gallant, M.D., M.P.H.
Joel Gallant, M.D., M.P.H.

Going to the doctor is not exactly the easiest thing to do -- you have to take time off from work, pay your copays, and cover any expenses related to the visit. So, for those who are highly adherent to a successful HIV regimen, do you have to go to the doctor every four to six months?

Those looking for a doctor's opinion need look no further than Joel Gallant, M.D., M.P.H. On his personal Tumblr, Dr. Gallant, an HIV doctor at Southwest CARE Center in Santa Fe, New Mexico, answers questions about a host of issues related to HIV treatment and prevention. He recently fielded a question from an anonymous user who was hoping to find out whether he could see his doctor a little less frequently.

The anonymous user asked:

Dr. Gallant, is it really necessary for a person who's super adherent to antiretroviral therapy to have his/ her CD4 and viral load checked every 4-6 months? Isn't it evident that, for such a committed patient, his/ her numbers will always be great?

Dr. Gallant answered:

The current Department of Health and Human Services (DHHS) guidelines recommend getting your viral load checked at a minimum interval of six months, and more frequently when you've recently started meds. CD4 counts are considered optional if they're consistently above 500 and your viral load is undetectable.

There are several reasons why you shouldn't wait longer than six months to get labs drawn. First, you need to be monitored for treatment failure. I agree that failure is unlikely if you've been doing well for years and always take your meds, but getting labs drawn twice a year is a small price to pay for reassurance. Second, you need to be monitored for drug toxicity. For example, just because your kidney function was normal six months ago on a tenofovir-based regimen doesn't mean it's still normal now. Waiting longer than six months could be risky.

You can ask Gallant a question directly on his Tumblr page, Ask Dr. Joel.